Eli's Hospice Insider

Published on Tue Apr 26, 2011 PDF

Here's where you'll find everything you need to ensure compliance.

You now have an updated Medicare Benefit Policy Manual to reference and it hammers down all the nuts and bolts of your face-to-face encounter requirements.

The new manual makes clear your role in FEE. For instance, "a hospice physician or hospice nurse practitioner must have a face-to-face encounter with each hospice patient prior to the beginning of the patient's third benefit period, and prior to each subsequent benefit period," CMS says in the new manual language.

Or else: "Failure to meet the face-to-face encounter requirements specified in this section results in a failure by the hospice to meet the patient's recertification of terminal illness eligibility requirement. The patient would cease to be eligible for the benefit."

The updated manual includes a host of other policy and technical changes made over the years, including clarification of responsibility for ambulance payment.

Resources: The transmittal containing the manual language is at http://www.cms.gov/transmittals/downloads/R141BP.pdf. A MLN Matters article about the changes is at http://www.cms.gov/MLNMattersArticles/downloads/MM7337.pdf.